Climate change, women’s health, and the role of obstetricians and gynaecologists in leadership

The climate crisis has become a public health emergency that disproportionately affects pregnant people, children, those from disadvantaged and marginalised communities, and people of colour, including Black, Brown and Indigenous people.

In a special article published in the International Journal of Gynecology & Obstetrics, leading obstetricians and gynaecologists (OBGYNs) highlight the impact of the climate crisis on human reproduction and the fundamental risks it poses to the very continuation of our species.

The article places climate change in the context of women’s reproductive health as a public health, social justice, human rights, economic, political and gender issue that needs immediate attention for the health and wellbeing of this and future generations. It emphasises how, by virtue of their position as trusted health care practitioners, OBGYNs have a unique opportunity to raise awareness, educate, and advocate for mitigation strategies to reverse climate change affecting patients and families.

A clear and present danger to humanity

Following publication of this world-leading research, the International Federation of Gynecology and Obstetrics (FIGO) joins a broad coalition of international researchers and the medical community in stating that the current climate crisis presents a clear and present danger to pregnant people, developing fetuses, and to the reproductive health of women and girls around the world.

Even with widespread knowledge and understanding of climate change among OBGYNs, FIGO advocates for governments around the globe to implement policies that address the root causes of climate change, including fossil fuel production, as the only way to minimise the impact of climate change on the health of women and girls. As portions of the planet become uninhabitable in the coming decades at the current rate of fossil fuel emissions, climate change poses an existential threat to a great portion of humanity.

The time to act is now.

The impact of climate change on the environment and illnesses

As a result of unabated human consumption of fossil fuels, the climate crisis has led to record increases in flooding, wildfires, droughts, vector-borne illnesses and a rise in global temperature that the United Nations’ Intergovernmental Panel on Climate Change characterised as a “code red” for the planet and for humanity.

These environmental conditions exacerbate heat and air pollution-related, as well as vector-borne, illnesses that harm human health:

• Excess heat exposure is attributed to more fatalities than any other weather hazard in the United States, and extreme heat is now documented worldwide.
• Extreme heat reduces crop production, food security, clean and safe water, and is linked to increases in low birthweight, prematurity, stillbirth, fetal congenital anomalies such as heart defects, diminished cognitive ability, maternal hypertensive disease and placental abruption.
• Fossil fuel combustion releases particulate matter less than 2.5 and 10 microns (PM_2.5 and PM₁₀, respectively), which is especially injurious to lungs, hearts and placentae. Excess global deaths, prematurity, low birthweight, maternal hypertensive disorders, impaired fertility and diminished success with in vitro fertilisation have all been attributed to these particulate emissions.
• Air pollution, including wildfire-related particulate exposure, has also been shown to increase susceptibility to, and death from, SARS-CoV-2 infection.
• Vector-borne illnesses such as malaria, dengue, schistosomiasis, Zika, and Chagas are just a few diseases expected to spread. Malaria is not only attributed to millions of deaths, but also to adverse pregnancy outcomes including intrauterine fetal demise, preterm delivery, fetal growth restriction and low birthweight.
• Climate change is linked to toxic chemical pollution. Fossil fuels are used in petrochemical production for chemicals used in plastics and consumer products, including flame retardants, PFAS and other endocrine-disrupting chemicals. These chemicals are universally found in pregnant women and can increase the risk of adverse health effects including obesity, diabetes, fertility problems, cancer and neurodevelopmental disorders.

Disproportionate impacts increase inequalities

The groups who experience the worst of these environmental injustices are typically least responsible for climate change emissions. Women are especially hard-hit, with decreased life expectancy from natural disasters, increased incidence of depression, anxiety and post-traumatic stress, and diminished access to health care to treat conditions as diverse as anaemia, malnutrition, menstrual difficulties and urinary tract infections.

Women also experience higher rates of sexual violence, sexual exploitation, abuse, trafficking and intimate partner violence, and greater challenges to accessing contraception and reproductive rights. Thus, climate change increases social inequities by amplifying underlying disparities that already exist across gender, sexuality, age, socioeconomic status, ethnicity and race.

Impacts across the lifespan

It is now clear that the ongoing climate crisis poses significant risks to women, pregnant people, unborn fetuses and offspring who were exposed in utero to climate stressors.

Adverse effects will reverberate across the lifespan of offspring and across generations. Individuals will be born disadvantaged by in utero climate-related insults, burdened with predispositions to disease (obesity, metabolic disorders, congenital defects, allergies, neurodevelopmental and psychological impairments) and ill-adapted to further climate impacts during their own lifetimes.

Calling OBGYN leaders to action

FIGO recommends that the climate crisis be recognised for the global emergency that it is and that health care providers lead as advocates, in research interpretation, capacity building and education. Both alongside and in support of the communities we serve, OBGYNs recognise the health consequences of the climate crisis and are key to supporting the changes necessary to address this crisis.

In this vein, FIGO’s International Journal of Gynecology & Obstetrics was a co-signatory of an unprecedented joint statement from editors of 220 leading medical, nursing and public-health journals calling the rapidly warming climate the “greatest threat” to global public health and urged world leaders to urgently cut heat-trapping emissions to avoid “catastrophic harm that will be impossible to reverse.”

FIGO is incorporating climate change into its Education, Advocacy and Research Programmes within its Committee on Climate Change and Toxic Environmental Exposures, so that global leaders from our member organisations can better effect change in their countries, regions and globally.

Read the full IJGO article on climate change and women's health now.